Sex addiction is all too often seen as a moral deficiency rather than a medical condition – a skewed perception that needs to change.

We caught up with David*, 45, who told us about how his battle with sex addiction has shaped his life, and why we as a society need to re-think our perceptions of what is, for many, a very real and debilitating illness.

1. It can be tough to pinpoint when the addiction starts…

"I realised that I had a problem that I needed to deal with I suppose in the late 2000's, around 2007/8. I had been paying for sex for roughly eight years, although it had only really become a regular thing two years or so before I sought help.

"At that time, the job I was doing involved travel, and paying for sex really became something I would do when I was abroad. I think I managed partly to almost delude myself into thinking that because I was abroad there was something – not romantic – but almost exotic about it and that I wouldn't do it at home. Like you're in a different place and different rules apply.

"Looking back it's obviously the same shit. You're still paying somebody to do something to them they probably wouldn't otherwise do without the money. But I guess when I paid for sex for the first time in the UK it really felt like I had crossed a boundary and it was then that I realised 'Oh God, this is something you get an immense thrill out of and you could be one of those people (the so-called perverts, the Johns) on the programmes, the documentaries.

2. …Or why

"At first, I didn't consider it a compulsion in any way. I did find it very intoxicating, but I would have never considered myself to be an addict. Now, it's clear that – for me – there is definitely a link between sex addiction and sex and love avoidance, in the sense that you know it's kind of about intimacy, and a fear of getting into a relationship and feeling you're not capable or worthy of it and all those things are tied into it so it's just easier to 'export' those problems into faceless no strings sex. I feel that I am [capable of intimacy] now, but back then I wasn't, just for whatever reason.

"I did have a couple of abortive relationships when I was dating where I either decided not to pursue them, behaved in an erratic way, was not honourable to the woman I was with or just wrote things off without any warning. There was one time when I stood up a girl I was dating on Valentine's day. She said to me 'Look, you know, I'm disappointed and I think we could have had something but all that aside, I really think you've got to look at your behaviour because it's just not normal'. I was upset by that – I didn't understand why I liked her but I couldn't get close to her; I sabotaged a potential relationship.

It's kind of about intimacy, and a fear of getting into a relationship and feeling you're not capable or worthy of it

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"The progression of the condition can be fast and baffling. I would find myself on the way to cash point full of craving, sexual fantasy and experiencing palpitations saying all the way there 'I don't want to do this. I don't want to do this.' But still getting the cash out and then on the way to dingy flats on the way to see a prostitute with the same internal monologue 'I don't want to do this. I don't want to do this.' But going through with it anyway and feeling terrible. Then swearing I'd never do that again. But finding myself doing the same thing a month later. It's as though I wasn't able to stay stopped despite wanting to do so – not liking what you're doing but lusting overcoming dislike.

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"One night I was out with a girl I was dating with some friends on my birthday. On the way back to her place, I stopped the cab saying 'I can't do this' and then ending up paying for sex. That I suppose symbolises the two aspects of my addiction: the fear of true intimacy and fleeing that in favour of the thrill that had the magic of illicit sex. Although I wouldn't say that it was necessarily the bottom line – it's more just emblematic of the problems I was having but around that time that was the last time I paid for sex. I would always justify this to myself by saying that I didn't want to export all my deficiencies into a relationship but that with porn stars I didn't have to engage with awkward emotions, or expose my vulnerabilities to a 'real woman'.

3. It's not just about sex

"From what I have seen, I think it's a bit of a myth that people with sex addiction have loads of sexual partners. It's true of some people I've heard about but I've not had that many sexual partners to be honest – I would say no more than 30 to 40 in my life, nothing hugely abnormal.

"To be honest the stuff I was doing more compulsively around that time was looking at porn sites and calling sex lines, which became somewhat of a Friday night ritual. Phone lines, maybe some dating sites, porn and then sometimes I'd move on from porn to the prostitutes. I'd very rarely go through with that but when I did, I did.

"OK, I paid for sex but I was also feeling shame around looking at porn all the time and… I connected the two and knew my life was becoming narrow. I didn't want to hang out with couples because I just resented couples and I wasn't really dating. I remember a few times watching porn before dates and feeling shame both before and after (watching and masturbating to porn regularly really affected my confidence and feelings of self-worth) and somewhere in my mind I realised there was a connection between the fear I felt around relationships and dating and all the other stuff.

"Feeling worry and avoiding sex for whatever reason because it's scary or you've had a bad experience or because it's the wrong sort or whatever can be part of the addictive personality. It is again a very one dimensional view that sex addiction is about liking sex. It's really more about the fantasy and escapism rather than the actual act of sex.

4. It's a seriously debilitating condition…

"After a while I realised that my life was becoming empty and I could notice that there was a compulsivity to the porn and that I would spend a lot of time on it. I didn't like the way that I spent hours doing it – it left me tired, it left me irritable. It can take you to some dark places including self-destructive or suicidal thoughts.

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"There's a saying in recovery that a lot of addiction is a symptom of an underlying cause which is when you get irritable, distressed, restless and discontented. It's that discontent – feeling dissatisfied with life at a certain level, you want stimulation, it can be about boredom but for me it was definitely a bit more deep-seated – that leads you to search for something to take you out of yourself. Porn is so chemically addictive and so powerful that it becomes your drug of choice and then it plays on your mind. It is quite unnerving when you feel triggered, it is like a haunting with physical compulsion and mental obsession which at the time feels quite painful to resist. There is an inevitability about it somehow, you feel a chemical pull towards it, and the scariest thing is that when you engage (far from slaking the lust) it just makes it worse.

"It's also like some other addictions or substances in that it does have a withdrawal response. So if you've engaged with it and then stopped you do get terrible pangs of desire, headaches, feelings of anxiety, depression, insomnia as well as negative thought spirals.

"The question of whether or not it's a mental illness is likely to cause controversy because technically sex addiction is not classed as such, but my own personal understanding is that if you have something that affects your thinking, the way you feel, affects your wellbeing and makes it more difficult to deal with life – if that isn't a mental illness, then I don't know what is. The fact is that it causes suffering, genuine suffering, and makes life more difficult, and therefore it needs to be managed.

5. …Which we need to start taking seriously

"This is just my personal view but I still think that when we as a society think of sex addiction, we picture high profile rich men having their way with a long line of women. It's often seen as a pretext for misbehaviour and – while I'm sure that's true in some cases – I know men who are not 'high status' who have done things they don't want to do – and it's not necessarily anything to do with having affairs. It might be voyeurism or all sorts of other things. But it's not the behaviours themselves, it's the mental obsession around sex that more defines the condition.

"I think that with pornography there always tends to be a moral argument. But sex addiction is not about prudery or permissiveness, it's a condition, a physical condition that isn't actually all about sex, it's more about sex as escapism, like a drug that makes us act out via masturbation or voyeurism or whatever that takes us away from ourselves and then becomes addictive. It's a sort of condition that involves sex but is more about an intoxicating high. And sex addiction affects people in many different ways and it's not that people like me don't like sex, it's more that we have an allergy to things that other people can be completely fine with. So, over time, I've had to re-learn how to engage with sex in an intimate relationship, which was very scary.

It sounds like a life sentence but it's not

6. You're not alone

"When I was told by a psychosexual therapist that I had a problem with sex addiction he told me that "It sounds like a life sentence but it's not. There is help and you can live with it but getting rid of the behaviours is hard and you've got to replace them with positive behaviours." First of all, I had to admit that I had got a problem and then it helped me to talk about it with people who understand and obviously, given the nature of sex addiction and stigma around it, it was better to speak with people who have similar issues. That's why support groups are really helpful because they enable recovery in an encouraging atmosphere where nobody is shamed for having something that is a chemical addiction – it's not something they've chosen.

"It was really about allowing myself to be helped and also by helping others. I talk about my story because it's helpful to others – partly because I think there's a lot of social stigma around this stuff. It's about getting a message out to people who are suffering now so that they can be told that this is a thing that exists let them know they're not going totally mad on their own and that there is help out there. I've lived the experience and therefore I can give people a reality check, plus it helps me stay away from addiction when I help people by sharing my experience.

"Mindfulness and meditation is another huge one for me, because the craving and the thoughts – just all the trouble with addiction for me – starts off in the mind. So, if my mind is full of restlessness and lack of focus and worry then I'm more prone to falling prey to my addiction.

"I also go to a 12-step programme recovery group. The principle of the 12 steps is to do with realising that addiction goes quite deep and that most addictions are rooted in selfishness, resentment and fear and trying to root that out and helping others. It sounds corny but that's the way I've experienced it and it does actually work. A 12 step programme offers you support, identification and encouragement to lead a life where sex doesn't become a problem. It has helped me to leave behind behaviours that make me feel ashamed or which I believed were harmful to myself or others. It's not about saying sex is wrong, it's just that for some of us there are compulsive behaviours that are hard to change on their own without outside help."

For more information on sex addiction, to seek help, or to find out about recovery meetings and support groups near you, visit Sex Addicts Anonymous (SAA).

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